Are diagnostic X-rays safe during pregnancy?

X-rays are a form of invisible radiation. Diagnostic X-rays are done to diagnose a condition while therapeutic X-rays are done to treat a certain condition, usually some kind of cancer. A chest X-ray would be a diagnostic X-ray to diagnose a condition in the chest, and a dental X-ray would be done to check your teeth.

While unnecessary radiation exposure should generally be avoided while pregnant, diagnostic X-rays to determine or diagnose a condition or disease are safe. The radiation associated with diagnostic X-rays are well below unsafe levels and there is no evidence that they will harm the fetus. In addition, most X-rays are done away from the uterus and the abdomen is usually shielded to prevent radiation from getting there.

If there is a good reason for a chest X-ray (for example), or a dental X-ray, or other tests, the amount of radiation exposure to the fetus is minimal, especially when the abdomen is shielded with lead. In fact, according to some experts, you might receive a similar amount of radiation by taking several commercial airplane flights (due to cosmic radiation from the sun and other stars). There is no evidence that modern microwave ovens or computer terminals expose women or their fetuses to harmful radiation.

How does a woman’s or man’s age affect fertility?

Fertility is defined as the capacity to produce children. As women get older, their fertility decreases. Once a woman passes 30, her fertility decreases significantly each year.  Within individuals, the chance of getting pregnant remains relatively stable from cycle to cycle. However, the chance of getting pregnant is highest in the first months of unprotected intercourse and declines gradually thereafter in the population as a whole. If no conception occurs within 3 months, monthly fecundability (the probability of pregnancy per month) decreases substantially among those who continue their efforts to conceive.

Fertility varies among populations and declines with age in both men and women, but the effects of age are much more pronounced in women. Relative fertility is decreased by about half among women in their late 30s compared with women in their early 20s.  For women over age 35 years, an infertility workup is recommended after 6 months of trying to get pregnant unsuccessfully or if there are known issues.

Pregnancy rate (per 1,000) by a woman's age in different populations.
Pregnancy rate (per 1,000) by a woman’s age in different populations.

Although semen parameters in men also decline detectably after 35 years of age, male fertility does not appear to decrease appreciably before approximately age 50.

Is it negligent to use Cytotec (misoprostol) for labor induction without adequate patient consent?

Negligence is the “failure to take proper care of doing something”. It is one of several parts constituting malpractice. To commit malpractice four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty (eg negligence); (3) injury caused by the breach; and (4) resulting damages.

Items that can potentially constitute negligence on behalf of a hospital or doctor include:

  • Potentially dangerous drugs are given without first confirming that the mother was properly informed about all the risks (no informed consent).
  • There are no detailed protocols (instructions) in place for the drugs’ proper use.
  • Physicians and nurses are not properly trained to recognize and treat complications (eg excessive uterine activity and fetal heart rate changes when inducing labor).

Cytotec or misoprostol is a medication approved for treating stomach ulcers. Though it is not FDA approved for that purpose, obstetricians and hospitals often use Cytotec for inducing labor. There are potentially serious problems associated with Cytotec during pregnancy. When given early in pregnancy, Cytotec could act as an “abortifacient”, a drug to induce an abortion or termination of the pregnancy. Later in pregnancy Cytotec can induce contractions of the uterus and labor. Like with many other medications during pregnancy, all patients given Cytotec must be thoroughly informed about its benefits and risks (informed consent).

From the FDA: This Patient Information Sheet is for pregnant women who may receive misoprostol to soften their cervix or induce contractions to begin labor. Misoprostol is sometimes used to decrease blood loss after delivery of a baby. These uses are not approved by the FDA. No company has sent the FDA scientific proof that misoprostol is safe and effective for these uses. Read More….

From the FDA: Cytotec (misoprostol) Prescribing Information: “A major adverse effect of the obstetrical use of Cytotec is hyperstimulation of the uterus which may progress to uterine tetany with marked impairment of uteroplacental blood flow, uterine rupture (requiring surgical repair, hysterectomy, and/or salpingo-oophorectomy), or amniotic fluid embolism. Pelvic pain, retained placenta, severe genital bleeding, shock, fetal bradycardia, and fetal and maternal death have been reported.” Read More….

From the NIH website: “The cost in terms of human life and the resulting permanent damage that Cytotec can do cannot be measured, although the number of deaths represented on the Safe Motherhood Quilt Project, coordinated by Ina May Gaskin (2008), continues to rise.” Read More….

In Dec. 2001, Tatia Oden French entered a well-known and well-respected hospital to deliver her first child. She was 32 years old, in perfect health, and looking forward to a natural childbirth, without any interventions or drugs. There were no problems during the pregnancy. According to her doctor’s calculations, she was a little under 2 weeks overdue. She was given the drug Cytotec to induce her labor. Cytotec, also known as Misoprostol, is a drug manufactured to treat ulcers. It is NOT approved by the FDA, or the drug company, to induce labor. Ten hours after being administered Cytotec, Tatia suffered hyper-stimulation of her uterus, an amniotic fluid embolism (AFE) was released, an emergency C-Section was performed because the baby was also in distress. Both Tatia and her baby Zorah died in the operating room. Read More….

Cytotec: Dangerous experiment or panacea? Read More….

“$9.566 Million for Improper use of Cytotec to Induce Labor Leads to Brain Injury.” Read More….

“$70 million Birth Injury Case – Largest Arbitration Award in U.S. History (Cytotec Brain Injury).” Read More….

“Cerebral palsy after birth injury during VBAC.” Read More….

Misoprostol (Cytotec) can cause birth injuries or maternal death. Read More.

Malpractice suit for Cytotec. Read More….

“As a result of 9.5 hours of Cytotec-induced excessive contractions, the baby was born with severe hypoxic-ischemic encephalopathy and multiple brain bleeds, resulting in intellectual disability, cerebral palsy, and a need for 24-hour around-the-clock care.
Patients should be fully informed of the risks and benefits of any medications prescribed to them, as well as any treatment options they are offered. Patients can ask questions regarding the specific benefits and potential drawbacks of any interventions their medical staff suggest, but – ultimately – it is the doctor’s responsibility to notify their patients about potential risks.” Read More….

Adverse Events Following Misoprostol Induction of Labor (A list of 16 cases). Read More….

Klonaris-Robinson was 38 and a half weeks pregnant with her second child when she was given Cytotec, a medication used to induce labor. At first, everything seemed normal as she started to have contractions. About 10 hours later she was given a second dose. Her contractions were coming much faster and now she had a sharp pain in her left side. “It went on and on, and I just kept saying, ‘Please, this pain doesn’t feel right.’”
“Two hours later, they finally listened and it was too late,” she said.
Her uterus had hyper-stimulated and tore top to bottom, front and the back. She was bleeding out and her daughter Meah was dead.

The death of Sofia Figus three days after she was born was caused by a lack of oxygen to the brain during a difficult birth. Her mother Anne Willicombe, 39, a university lecturer, was 12 days overdue when she was prescribed Misoprostol – a drug widely used in abortion clinics – to bring on contractions. Read More….

Are mothers properly informed?

If there are “Cytotec attorneys” then there must be a market. Read More….

Jessica & Justin: Why home birth is not best … for baby or mom

Jessica Biel and Justin Timberlake recently revealed that Jessica had to be rushed to the hospital to have an emergency cesarean section to deliver their son, Silas, when  plans for a home birth went awry.

Biel says that despite months long planning to deliver at home with no intervention, “all our plans fell apart and the serene, natural childbirth we had envisioned ended with a transfer to the hospital and an emergency C-section.” Luckily, Biel and her son survived. Not everyone is as lucky and I sincerely wish them the best.

Naturally, it is important to plan for a birth with the least intervention possible for both mom and baby; however, it is also vital to have the proper medical staff and equipment at a moment’s notice. There is a reason why interventions are available in the hospital. They can make mom more comfortable (like an epidural) and they can save lives. Laboring and delivering in the hospital, even in hospital-based birth centers, will help secure the best outcome possible for you and your baby. Labor is unpredictable, and no matter how much planning you do, you just cannot predict what may happen: a problem with the placenta may occur, the baby’s heart rate may drop quite suddenly, or the baby may get stuck in the birth canal. Before hospital deliveries, neonatal and maternal injuries and deaths were atrocious.

The only way to ensure the safest delivery is to be in a hospital with an operating room ready should you need it, even in a hospital-based birth center. Interventions such a cesarean sections have saved babies’ lives. While the idea of delivering your baby at home may sound like a calm and soothing way to bring your baby into the world, encountering the chaos of having to be transferred to a hospital because of an emergency complication is the quite the opposite. Arriving at a hospital is chaotic and uncoordinated, and the staff is pulled away from taking care of other patients. No one has been set aside for you because no one knew you were coming. When you deliver in a hospital, whether is the regular birth unit or a birth center inside the hospital, under the care of an OB/GYN or certified nurse midwife (CNM), the staff has been assigned to care for your specific needs and if you should need an emergency cesarean section, the staff is not only ready to go but nurses and doctors have previously scheduled time for you, have charts on hand, your personal labor progression chronicled, and any medical issues accounted for. It is all a very systematic process in which you and your baby have a team of medical professionals overseeing the process.

In addition, there are times when a cesarean section must be performed in minutes (if not seconds) because of complications such as a cord prolapse or an abruptio placentae.  That is not a time to be 10- 15 minutes or more, away from a hospital and then be transported via an ambulance to an unknowing, unprepared staff that knows nothing about your labor. If you want to provide maximum health and options for mom and baby, that can only be achieved in a hospital with operating rooms ready for emergency cesareans sections, and a capable staff ready to go. That is the best way to bring a baby into the  world. In addition complications such as a shoulder dystocia can happen even in normal pregnancies, and having a team available will improve your baby’s chances of being born healthily.

A hospital birth can be very miraculous and beautiful. If you want your delivery to be done as you like, create a birth plan and discuss it with your doctor or midwife. Safeguarding your baby’s health and your own is the best way to ensure a calm and comforting birth day for your child, which will remain a special memory for years to come.

How safe is dental work in pregnancy?

There are many pregnancy safety myths when it comes to dental health and hygiene, from losing a tooth for every baby you have to weakened teeth from calcium loss. Fortunately, none of these myths is true. Yet another myth is that it is unsafe to have dental work and X-rays during pregnancy. In actuality, the opposite is true. By practicing good dental hygiene and care before, during, and after pregnancy, every woman can ensure that her teeth remain healthy for a long time.

Preventive dental cleanings and annual exams during pregnancy are not only safe but recommended. The rise in hormone levels during pregnancy can cause the gums to swell, bleed, and trap food, causing increased irritation to the gums. Recent studies have shown an association between poor dental conditions and pregnancy complications such as preterm delivery and low birthweight babies.

Preventive dental work is essential to avoid oral infections such as gum disease, which has been linked to preterm birth. As a result, it is recommended that all pregnant women and women trying to conceive see their dentist regularly, at least every 6 months.

Periodontal gum disease is an infection of the gums and bone, caused by plaque, a sticky film of bacteria that adheres to teeth; pregnant women are especially susceptible to this gum disease. It is known that periodontal disease can adversely affect the pregnancy, though information is lacking as to how and why these negative effects occur.

Research suggests that the bacteria that cause inflammation in the gums can actually get into the bloodstream and target the fetus, potentially leading to premature labor and low birth weight babies. One study even shows an increased risk of preeclampsia in women with periodontal disease.

To decrease your risk and to prevent the development of periodontal disease, it is important that you see your dentist before and during pregnancy. For women who are planning to get pregnant, a thorough periodontal exam and appropriate treatment should begin prior to pregnancy. Meticulous oral hygiene and frequent professional cleanings may also be helpful. Dental work such as cavity fillings, crowns, and even root canal treatment should also be done before and during pregnancy to reduce the chance of infection.

Local anesthesia as well as dental X-rays with abdominal shielding are safe during pregnancy and will not affect the fetus. Antibiotics such as penicillin, amoxicillin, and clindamycin, which are labeled category B for safety in pregnancy, may be prescribed after your procedure. Elective tooth treatments, such as teeth whitening and other cosmetic procedures, however, should be postponed until after birth.